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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832 -8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />Bill Ritter, Jr. <br />CHECK ONE: There is a File Number Already Assigned to this Operation Governor <br />p M _ 19 _ 97 007 Harris D. Sherman <br />(Please reference the file number currently assigned to this operatio* ecutive Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - _ 97 007 (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete slimed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder maps should be folded to <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print c7eaarly,iin - the space provided, ALL information requested below. <br />1. Applicant/operator or company name (name to be used on permit): The Denver Brick Company <br />1.1 Type of organization (corporation, partnership, etc.): corporation <br />2. Operation name (pit. mine or site name): BijOU Clay Mine <br />3. Permitted acrealre (new or existing site): <br />3.1 Change in acreage ( +) <br />3.2 Total acreage in Permit area <br />4. Fees: - <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: clay <br />5.1 Incidental commoditie(s) to be mined: 1. <br />3. / <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of <br />Mined Land Reclamation <br />lbs/Tons/vr 4. / <br />Denver • Grand Junction • Durango <br />STATE OF COLORADO <br />lbs/Tons/vr 2. / <br />lbs/Tons/yr 5. / <br />brick manufacturing <br />21.75 <br />12.00 <br />33.75 <br />COLO <br />DIVISI O F <br />RECLAMATION <br />MINING <br />SAFETY <br />Ronald W. Cattany <br />Division Director <br />Natural Resource Trustee <br />permitted acres <br />acres <br />acres <br />$2.696.00 application fee <br />$3342.00 quarry application <br />$2,229.00 amendment fee <br />$2.696.00 conversion fee <br />lbs/Tons/yr <br />lbs/Tons/yr <br />Office of <br />Active and Inactive Mines <br />